Aijaz Ahmed Memon, Pir Sahib Shah, Hashim Langah, Ali Akber Ghumro.
Early experience with Laparoscopic Cholecystectomy.
J Surg Pak Jan ;9(3):2-5.

Objectives: To study the problems and complications that arose during initial experience with laparoscopic cholecystectomy. Design: Descriptive case study Place & Duration: This study was conducted at Peoples Medical College Hospital Nawabshah, from August 2000 to July 2002 for a period of 2 years. Patients And Methods: Forty two patients suffering from symptomatic cholelithiasis were admitted to surgical unit II and selected for laparoscopic cholecystectomy. Results: Laparoscopically completed cholecystectomies were 35/42 (83.33%). Seven patients required conversion to open method. Problems were encountered in 30/42 (71.42%) patients during laparoscopic cholecystectomy. These were dilated gallbladder adhesions, ascites, cirrhosis and obesity and the problems that originated during the procedure like bleeding, cardiac arrhythmias and gallbladder perforation. Seven conversions were among these problem cases. Two patients 2/35 (5.71%) treated laparoscopically developed complications and these were bile leak and collection of haematoma. There were no bile duct or major vessel injuries and there was no mortality. Conclusion: Some of the problems that are faced during laparoscopic cholecystectomy can be avoided by early detection before laparoscopy like ascites & cirrhosis. Other problems can be avoided or dealt with efficiently during the procedure by a well-trained and experienced team, in order to minimize the chances of conversion to open surgery.

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